Last fall's rollout of HealthCare.gov was nothing short of a mess. / Jon Elswick, AP

by Kelly Kennedy, USA TODAY

by Kelly Kennedy, USA TODAY

WASHINGTON - A new report finds that the government did not plan well or properly provide oversight for the new federal health exchange launched last October.

And the website faces new headaches for open enrollment in the fall if officials don't control spending, increase oversight and ensure back-end issues are properly fixed.

The Department of Health and Human Services "needs a mitigation plan to address these issues," wrote the report author, William Woods, director of acquisitions and sourcing management for the Government Accountability Office. Unless the government "improves contract management and adheres to a structured governance process, significant risks remain that upcoming enrollment periods could encounter challenges."

A new contract went to Accenture Federal Services to take over the site in January after the original contractor, CGI Federal, was essentially dropped after the poor launch. But Accenture's original contract for $91 million has increased to more than $175 million, and some of the back-end issues on the site are still not working, according to the report, which will be presented in a House hearing Thursday.

When HealthCare.gov went live, consumers shopping for private insurance through the site faced long wait times, frozen pages and a broken log-in system. The government had the site working properly for consumers by the end of November but still faced problems on the back end with insurer and financial transactions even after open enrollment ended in the spring.

The Centers for Medicare and Medicaid Services went ahead with the exchange "despite facing a number of challenges that increased both the level of risk and the need for effective oversight," according to the report. Health and Human Services ultimately enrolled more than 8 million people in private insurance through the exchanges during open enrollment, surpassing its original goal of 7 million people.

But GAO investigators found that contractors building the exchange had too little time to do the job, and faced too many changes from the government as they tried to build.

The report states:

â?¢ Contractors had to build the data hub without knowing how many states would participate;

â?¢ Contracting officials had to finalize new contracts without knowing exactly what the requirements would be, leading to more money spent than was originally expected;

â?¢ Contracts with unusual amounts of flexibility because of changing requirements should have had more oversight to prevent overspending;

â?¢ The federal marketplace was originally expected to cost $30 million, but increased to $85 million;

â?¢ The site was launched without verification that it met performance requirements;

â?¢ Because of inconsistent contractor oversight, there was confusion about who had the authority to approve contractor extensions. $40 million worth of work, though it may have been necessary, was improperly approved;

â?¢ The government almost decided to withhold the fee for CGI Federal last summer but instead decided to try to meet the October deadline for launch with CGI as the contractor.

Woods will appear before the House Energy and Commerce Committee, along with Andy Slavitt, principal deputy administrator at CMS, on Thursday morning.